title: Nutritional Status and Other Baseline Predictors of Mortality among HIV-Infected Children Initiating Antiretroviral Therapy in Tanzania.
abstract: BACKGROUND
  We assembled a prospective cohort of 3144 children less than 15 years of age initiating antiretroviral therapy (ART) in Dar es Salaam, Tanzania.
  
  
  METHODS
  The relationships of nutritional status and other baseline characteristics in relation to mortality were examined using Cox proportional hazards model.
  
  
  RESULTS
  Compared with children with weight for age (WAZ) > -1, those with WAZ ≤ -2 to < -3 had a nearly double risk of death (relative risk [RR], 1.85; 95% confidence interval [CI], 1.10-3.11), and among those with WAZ ≤ -3, the risk more than tripled (RR, 3.36; 95% CI, 2.12-5.32). Other baseline risk factors for overall mortality included severe anemia (P < .001), severe immune suppression (P = .02), history of tuberculosis (P = .01), opportunistic infections (P < .001), living in the poorest district (P < .001), and advanced World Health Organization stage (P = .003).
  
  
  CONCLUSIONS
  To sustain the obtained benefit of ART in this setting, interventions to improve nutritional status may be used as an adjunct to ART.
authors.affiliation: Department of Nutrition, Harvard School of Public Health, Boston, MA, USA Management and Development for Health (MDH), Dar es Salaam, Tanzania rastemwi@mail.harvard.edu.
authors.forename: Ramadhani S
authors.initials: RS
authors.lastname: Mwiru
authors.affiliation: Department of Biostatistics, Harvard School of Public Health, Boston, MA, USA Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA.
authors.forename: Donna
authors.initials: D
authors.lastname: Spiegelman
authors.affiliation: Department of Nutrition, Harvard School of Public Health, Boston, MA, USA Division of GI/Nutrition, Center for Nutrition, Boston Children's Hospital, Boston, MA, USA.
authors.forename: Christopher
authors.initials: C
authors.lastname: Duggan
authors.affiliation: Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA.
authors.forename: George R
authors.initials: GR
authors.lastname: Seage
authors.affiliation: Ministry of Health and Social Welfare, Dar es Salaam, Tanzania.
authors.forename: Helen
authors.initials: H
authors.lastname: Semu
authors.affiliation: Department of Nutrition, Harvard School of Public Health, Boston, MA, USA Management and Development for Health (MDH), Dar es Salaam, Tanzania.
authors.forename: Guerino
authors.initials: G
authors.lastname: Chalamilla
authors.affiliation: Department of Pediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
authors.forename: Rodrick
authors.initials: R
authors.lastname: Kisenge
authors.affiliation: Department of Nutrition, Harvard School of Public Health, Boston, MA, USA Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA Department of Global Health and Population, Harvard School of Public Health, Boston, MA, USA.
authors.forename: Wafaie W
authors.initials: WW
authors.lastname: Fawzi
mesh_terms: D019380:Anti-HIV Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000401:mortality* / Q000503:physiopathology; D006801:Humans; D007223:Infant; D008297:Male; D009752:Nutritional Status; D011446:Prospective Studies; D013636:Tanzania
chemical_list: D019380:Anti-HIV Agents
keywords: AIDS; HIV; Tanzania; children; mortality